topical vs injections

[GettingAnswers]

I am still on 10mg compounded daily plus 250iu HCG 2x/week and not sure if anyone puts stock in saliva results, but here are mine

DHEA/s 11 (3-10) HIGH
Progesterone 90 (5-95)
Androstenedione 499 (151-350) HIGH
Estrone 128 (30-58) High
Testosterone >200 (50-80) HIGH
Estradiol 5 (1-3) HIGH
DHT >250 (52-123) HIGH

 

[cocarr]

Update......

Labs done on 5-12-2014. My PCP called me this AM with the results. Unfortunately since he called me I do not have the ranges at hand. This round we only did the main 3 labs.

Testosterone 689 up from 239 eight weeks ago.
Free T 18
Estradiol sensitive 12

The strange thing is I do not feel much different. My wife has noticed me sleeping just a touch less and I have lost 10lbs although that has more to do with me consciously trying to get some weight off and the weather is warming up so I have been outside doing my spring yard stuff some of which was a lot of labor.

My Dr. thinks that it may go up some more so we held my Andro at the 5gm dosage. I am really happy that the gel is working as I know many studies show it to have less side effects. My only drawback is the fact that I honestly do not feel different and my free T alone being at 18 (the top of the range is 24) seems like I should be noticing it more......... I know Nelsons' graphs show how slow the effects really are but this was a fairly large jump.

 

[Gene Devine]

Every one is different in how long things take.

It took me a good 6 months before I began to see the difference and libido kicked in.

Give it time; TRT is great but it doesn't happen overnight.

 

[SuperDutyDave]

Ill echo Gene on the timing thing.....it takes a good 6 months and that's assuming that you are dialing in and not missing the mark with either your treatment plan and/or your body is not overly adjusting.
It took me a year plus to get things really rolling and even then small tweaks continue two years later.

Its really and art not a science One size does not fit all.....its critical that you have great dialogue with a doctor who is treating with TRT daily.

 

[cocarr]

The nice part is, as the saying goes, numbers never lie and the fact is I at least know that the gel is being absorbed and raising my levels up. I dont remember exactly but I think my free T was low single digits and my total being 229 then 239 after my first round has come up quite a bit. Libido has never been a problem for me performance wise although my urge has been a touch lower the last couple of years. I do have 3 kids 6, 4 and 8 months which in and of themselves are "libido killers" haa. Little terds can sense a hard on from 3 rooms away while they are asleep I am sure of it.

Gene would you expect my numbers to continue up a little bit even on the same dose? If it goes up a touch more I will be in the 700's and that seems like a good place to be initially. I also screwed up and failed to notify my pharmacy that I needed my refill and they had to order it so I missed my dose today.........hopefully that doesnt bite me too bad.

 

[Gene Devine]

Missing a dose on transdermals is not the end of the world. Just pick up where you left off.

It's possible your serum levels will continue to climb a bit more than stabilize. It's good that you are absorbing well and it's working for you.

Please tell me you are using HCG for all the good reasons that we know!

 

[cocarr]

Unfortunately not at this time. After you and I discussed it in another thread I brought it up again to my PCP and he is just unsure of how to go about it given the fact that he has never prescribed it before. I did not push the issue as I wanted to get my T treatment in a good place before I talked with him again about it. The whole part about HCG initializing cholesterol breakdown definitely got his attention. I printed out one of the links that you had put in that thread and I gave it to him last time I saw him. He has been very open to every one of my suggestions to this point but I think he is apprehensive about the HCG not necessarily because he doesnt approve but more of a lack of knowledge about it on his part.

Is HCG as important with the gels as it is with injections? I know many people (even you I think) have mentioned the gels being more natural. I am sure HCG would still be beneficial but would it be as critical?

 

[Gene Devine]

HCG is a must for any TRT protocol.

Once we initiate exogenous Testosterone, no matter the application, be it injection or transdermal, we basically are forcing Secondary Hypogonadism via HPTA suppression.

With HPTA suppression and the subsequent negative feedback loop LH/FSH stop being produced.

One cannot think stopping the production of needed hormones in a man's body is a good thing...it's not.

 

[Nelson Vergel]

I like HCG and have very strong biases for its use.

However, I do not think it is a "must" if you do not have testicular atrophy and low sex drive on testosterone replacement. Many guys have adherence issues with 2-3 times a week HCG injections and I really do not want them to feel inadequate for not using it if they do not perceive a need.

I love HCG but wanted to clarify my views on its use.

 

[Gene Devine]

And I respect your view but I still stand by my point; one cannot believe that deliberately shutting down two hormones in LH and FSH and not think there are some metabolic repercussions.

Does a man need HCG on TRT?

Nope.

But it's way better for their health when they are.

It's why almost every TRT Doc worth their salt includes it in their protocols...they all can't be wrong.

 

[cocarr]

I may be wrong but I thought eventually your body recognizes that HCG is in fact not LH and you build up a tolerance to it so to speak. I do know on the bases of increased cholesterol with guys on T and the growing amount of circulatory problems with many guys on treatment that the benefits of HCG in that regard seem like a good idea. Keeping that cholesterol down is very important.

My Dr. did make a good point though when he said he worried about playing with "too many" hormones. I am his youngest patient by far and I am really his only "T" patient who is there for reasons other than libido. It is a learning curve for both of us.

 

[SuperDutyDave]

Never heard of a tolerance issue with HCG. Been taking it for couple years no issues. It does keep the boys from turning into raisins and it also keeps other hormonal issues happening. Sounds like your doc is just scared of it as he is unfamiliar and it definitely requires you injecting frequently


I recommend it as do most others

 

[GettingAnswers]

So here is an amateur question I asked my doc because I was feeling bad again on the topicals. He said the idea intrigued him.

A thought about topical application. Is it in any way feasible that topical testosterone gets ‘bound' in the lymphatic system and could lead to the elevated salivary levels seen in my last testing? I find it odd that at only 10mg a day my levels were out of range. Coupled with the fact that over the last 3 weeks, my sexual drive and function were diminishing daily, my weakness was coming back, my intense shortness of breath was returning, etc. As a trial, on Monday I injected merely 15mg of T Cypionate and by the next day my penile function was returning, my shortness of breath had abated dramatically and I once again had energy to start doing pull-ups and was able to play soccer with my son. All things that had been increasingly difficult the past few weeks. I do not plan to keep self dosing T, but it was done as a trial with a low amount to see if T levels or the T delivery system could be to blame.


I just can't help but think that even though topicals show high levels via skin prick or salivary, there has to be a reason that serum levels show it to be low. I know the ZRT explanation, but is that a good thing that it is trapped in capillary beds and not detected in serum? Could that imply that somehow it is trapped in surficial tissues and not readily transported to internal organs, deeper muscles fibers, heart, etc? The body is very smart and good at keeping invaders out but sometimes it doesn't know we are trying to help. Once a compound crosses the skin barrier is it distributed freely or is it possible that it can become ‘trapped' in the lymphatic and other systems for ‘filtration' and removal and thereby not available for use where it is needed?

 

[SuperDutyDave]

Can't speak to the trapped theory but can tell you I started on topicals Seemed to work to some degree for first few months.....but then symptoms returned and labs continued to drop even with increasing dosage and doing it twice daily

The switch to sub-q injections of both t-cyp and HCG solved the issue.

 

[cocarr]

My latest tests were all serum levels so I know the numbers are there. That said going from 229-700 seems like I would be feeling different/better. At this point I really do not feel any change whatsoever. It doesnt make any sense to me that injecting would be different if the numbers remained similar but maybe it would.

As to your "trapped" theory your capillary blood does not contain different values than your venous blood does. Obviously if you took the capillary test from the area which you applied the gel in a certain amount of time that could have some bearing on it. Blood sugar, cholesterol etc. can all be measured by both and the results are very similar with the difference being the instrument that it is tested on. As to salivary I have no idea but personally I would want blood tests done in its place.

I will ask my wife about this when I get home from work this morning and reply again tonight. She is a medical technologist and knows more about blood than most Dr's, barring pathologists.